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Affidavit For Delayed Registration of Birth: Name of Doctor/nurse/hilot Address of Hospital/hilot

The document is an affidavit for delayed birth registration. It requests information such as the applicant's name and birth details, parent names if applicable, reason for delay in registration, and purpose for needing the birth certificate. The applicant or their guardian must sign and swear to the information.

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Mike Datortiz
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277 views1 page

Affidavit For Delayed Registration of Birth: Name of Doctor/nurse/hilot Address of Hospital/hilot

The document is an affidavit for delayed birth registration. It requests information such as the applicant's name and birth details, parent names if applicable, reason for delay in registration, and purpose for needing the birth certificate. The applicant or their guardian must sign and swear to the information.

Uploaded by

Mike Datortiz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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(FOR THOSE REPORTING ONE MONTH AFTER THE CHILD'S BIRTH, KINDLY ACCOMPLISH THIS AFFIDAVIT)

AFFIDAVIT FOR DELAYED REGISTRATION OF BIRTH


(Either the person himself if 18 years old or over, or father/mother/guardian may accomplish this affidavit)

I, ______________________________________________________ of legal age,


singles/married, and with residence and postal address at _____________________
_________________________________________________, after having been duly sworn
to in accordance with law, do hereby depose and say:

1. That I am the applicant for the delayed registration of my birth / or the birth of
_________________________________________________.
2. That I / he / she was born on ____________________________________ in
____________________________________________________________;
3. That I / he / she was attended at birth by _____________________________
name of doctor/nurse/hilot who
resides at __________________________________________________;
address of hospital/hilot
4. That I / he / she is a citizen of _________________________________________;
5. That my / his / her parents were ________________________________________
indicate parents' full names
[ ] married on _____________________ in _______________________________
[ ] not married but was acknowledged by my / his / her father whose name is
__________________________________________________________________;
full name of father
6. That the reason for the delay in registering my / his / her birth was due to ______
__________________________________________________________________;
7. That a copy of my / his / her birth certificate is needed for the purpose of ______
__________________________________________________________________;
8. [ ] (For the applicant only) That I am married to ___________________________.
[ ] (For the father/mother/guardian) That I am the ______________________ of
the said person.

________________________________
(Affiant signature over printed name)

SUBSCRIBED AND SWORN to before me this .


_______ day of
.
____________________, 20_____
. Honolulu, Hawaii
in ______________
California, U.S.A.

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